Navigating The Complex World Of Workers' Comp Litigation

If your employer's insurance company denies your workers' compensation claim, isn't paying your wage loss benefits properly or timely, or refuses to pay for medical treatment, it is time to speak with an attorney that specializes in workers' compensation.

The insurance company has 21 days to accept or deny a workers' compensation claim. If the insurance company denies your claim, it should send you a Notice of Compensation Denial. Sometimes, an insurance company instead notifies the injured worker it is reviewing the claim and stretches the process beyond the 21 days it has to accept or deny a claim. Naturally, the injured worker becomes frustrated and wants to know why he or she is not receiving benefits. If the insurance company does nothing in 21 days, you can assume your claim is denied.

If you want to dispute the insurance company's actions of denying your claim and/or benefits, you must litigate your case before a workers' compensation judge. Although, you can litigate a claim yourself, it is not a good idea to do so. Given the complex nature of workers' compensation law, the judge always encourages you to review your claim with a lawyer. While litigating a workers' comp claim may be new to you, a multibillion dollar industry has developed to help the insurance companies reduce their exposure by denying claims and/or reducing a claim's value.

Your employer's insurance company will have experienced lawyers on their side. It is wise to put that same type of experience in your corner. Enlisting experienced legal counsel will increase your chances of success. Pennsylvania workers' compensation laws are complex. Full knowledge of proper procedures and the rights of injured workers is critical to successfully litigate a claim.

Litigating Claims Is What We Do

At Cullen Legal in Bristol, our objective is simple: we aim to maximize the workers' compensation benefits that injured workers receive. We bring a personal approach and genuine concern for our clients' health — physically and financially — to our work.

Workers' comp claims are denied for a number of reasons. Insurance companies, like any business, are focused on making a profit. They want to limit how much they pay out in claims. Common reasons for denied claims include:

  • The injury was not work-related
  • The injury was caused by a pre-existing injury or medical condition
  • The injury does not prevent you from performing your job
  • You are not injured
  • You missed the deadline for submitting a claim
  • You didn't report the injury to your supervisor and got fired as a result

Understanding The Appeal Process

The insurance company has 21 days from the day the injury occurred to accept your claim. If you have not been informed within that time frame, it is important to contact us immediatley.We will review your denied claim during a free consultation and give you a candid assessment of the strength of your case and what you can expect throughout the litigation process.

Even if the insurance company accepts your claim, it is a good idea to have us review your Notice of Compensation Payable to ensure you are getting all of the benefits you deserve. Often, there are mistakes on how your wages have been calculated or how your injury has been described. An error on the Notice of Compensation Payable can drastically reduced the amount of money or medical benefits you receive. Keep in mind, we do not collect an attorney fee at any point until we recover benefits for you.

Continue To Treat Your Injuries

Throughout the litigation process, it is critical to take certain steps to increase the likelihood of success. If you are being treated for your injury or illness, you must continue to receive treatment. If you are asked to see an independent medical examiner, you must do so. If your employer instructs you to return to work before you feel ready, in most cases you should show up and make the effort. All of this and more should be discussed with your attorney.

If you have already been through litigating a workers' compensation claim, either by yourself or with another attorney, and a judge found against you, you can appeal the judge's decision. An appeal can be filed with the Pennsylvania Workers' Compensation Appeal Board, which reviews the case and determines whether the workers' compensation judge was correct in denying your claim.

Our Personal Attention Will Keep Your Claim On Track

Attorney Robert L. Cullen will work closely with you at every step and communicate regularly in order to keep your claim litigation on track. He will help you make the important decisions that will prevent you from making missteps that could negatively affect your claim. Call 267-812-5870 to schedule a free consultation.